Effects of exercise and diet in patients with incurable gastroesophageal cancer: the RADICES study

Aniek Bonhof; Anouk E. Hiensch; Nicolette J. Wierdsma; Linde F. Huis In ‘t Veld; Sandra D. Bakker; Aart Beeker; Marjan Davidis-van Schoonhoven; Helga Droogendijk; Jan C. Drooger; Joeri A.J. Douma; Ruben S.A. Goedegebuure; Nadia Haj Mohammad; Irene E.G. van Hellemond; Karin Herbschleb; Johan J.B. Janssen; Bianca Mostert; Marije Slingerland; Dirkje Sommeijer; Liesbeth Timmermans; Arjan J. Verschoor; Vincent A. de Weger; Harm Westdorp; Miriam L. Wumkes; Anne M. May; Hanneke W.M. van Laarhoven

doi:10.1093/jncics/pkag006

Effects of exercise and diet in patients with incurable gastroesophageal cancer: the RADICES study

Aniek Bonhof
, Anouk E. Hiensch
, Nicolette J. Wierdsma
, Linde F. Huis In ‘t Veld
, Sandra D. Bakker
, Aart Beeker
, Marjan Davidis-van Schoonhoven
, Helga Droogendijk
, Jan C. Drooger
, Joeri A.J. Douma
, Ruben S.A. Goedegebuure
, Nadia Haj Mohammad
, Irene E.G. van Hellemond
, Karin Herbschleb
, Johan J.B. Janssen
, Bianca Mostert
, Marije Slingerland
, Dirkje Sommeijer
, Liesbeth Timmermans
, Arjan J. Verschoor

Vincent A. de Weger, Harm Westdorp, Miriam L. Wumkes, Anne M. May, Hanneke W.M. van Laarhoven^*

^*Corresponding author for this work

Medical Oncology

Utrecht University
Amsterdam UMC
Zaans Medical Center
Spaarne Gasthuis
Beatrix Hospital
Bravis Hospital (BOZ)
Frisius MC (Leeuwarden)
Meander Medical Center
Catharina Hospital
St. Antonius Hospital
Leiden University
Flevoziekenhuis
Radboud University Medical Center
Reinier de Graaf Groep
Haga Ziekenhuis
Jeroen Bosch Ziekenhuis

Research output: Contribution to journal › Article › Academic › peer-review

1 Citation (Scopus)

7 Downloads (Pure)

Abstract

Background Patients with incurable gastroesophageal adenocarcinoma have an impaired health-related quality of life (HRQOL). Exercise combined with nutritional support may improve this outcome. Careful evaluation of this supportive care strategy is needed to avoid burdening patients at this vulnerable stage with interventions that may offer no (meaningful) benefit. Therefore, this study aims to investigate the effects of a combined exercise and nutritional intervention on HRQOL in patients with incurable gastroesophageal adenocarcinoma. Methods RADICES (the effect of exeRcise And Diet on quality of life in patients with Incurable Cancer of Esophagus and Stomach) is a multicenter randomized controlled trial aiming to include 196 patients with incurable gastroesophageal adenocarcinoma. Participants are randomly assigned (1:1) to a patient-tailored intervention or a control group. The intervention group is provided with 2 training sessions per week and biweekly nutritional consultations, delivered by trained physiotherapists and dietitians, during 12 weeks. The control group receives usual care supplemented with general physical activity advice. The primary outcome is the difference in HRQOL between the intervention group and the control group at 12 weeks, accounting for baseline HRQOL, measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–30 summary score. HRQOL is assessed at baseline, 6 weeks, 12 weeks, and every 3 months thereafter up to 1 year. Key secondary outcomes include patient-reported outcomes, cardiorespiratory fitness, dietary intake, disease progression, overall survival, and cost-effectiveness. Adherence and safety are monitored throughout the intervention period. Conclusion This study will generate evidence on the effectiveness of a patient-tailored combined exercise and nutritional intervention in patients with incurable gastroesophageal adenocarcinoma. If effective for HRQOL, this intervention could be integrated into standard care for patients with incurable gastroesophageal adenocarcinoma. Trial registration clinicaltrials.gov NCT06138223. Date of trial registration: November 18, 2023 Date and version study protocol: 28-04-2025 version 3.1

Original language	English
Article number	pkag006
Journal	JNCI Cancer Spectrum
Volume	10
Issue number	2
DOIs	https://doi.org/10.1093/jncics/pkag006
Publication status	Published - Apr 2026

Bibliographical note

Publisher Copyright:
© The Author(s) 2026. Published by Oxford University Press.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Bonhof, A., Hiensch, A. E., Wierdsma, N. J., Huis In ‘t Veld, L. F., Bakker, S. D., Beeker, A., Davidis-van Schoonhoven, M., Droogendijk, H., Drooger, J. C., Douma, J. A. J., Goedegebuure, R. S. A., Haj Mohammad, N., van Hellemond, I. E. G., Herbschleb, K., Janssen, J. J. B., Mostert, B., Slingerland, M., Sommeijer, D., Timmermans, L., ... van Laarhoven, H. W. M. (2026). Effects of exercise and diet in patients with incurable gastroesophageal cancer: the RADICES study. JNCI Cancer Spectrum, 10(2), Article pkag006. https://doi.org/10.1093/jncics/pkag006

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title = "Effects of exercise and diet in patients with incurable gastroesophageal cancer: the RADICES study",

abstract = "Background Patients with incurable gastroesophageal adenocarcinoma have an impaired health-related quality of life (HRQOL). Exercise combined with nutritional support may improve this outcome. Careful evaluation of this supportive care strategy is needed to avoid burdening patients at this vulnerable stage with interventions that may offer no (meaningful) benefit. Therefore, this study aims to investigate the effects of a combined exercise and nutritional intervention on HRQOL in patients with incurable gastroesophageal adenocarcinoma. Methods RADICES (the effect of exeRcise And Diet on quality of life in patients with Incurable Cancer of Esophagus and Stomach) is a multicenter randomized controlled trial aiming to include 196 patients with incurable gastroesophageal adenocarcinoma. Participants are randomly assigned (1:1) to a patient-tailored intervention or a control group. The intervention group is provided with 2 training sessions per week and biweekly nutritional consultations, delivered by trained physiotherapists and dietitians, during 12 weeks. The control group receives usual care supplemented with general physical activity advice. The primary outcome is the difference in HRQOL between the intervention group and the control group at 12 weeks, accounting for baseline HRQOL, measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–30 summary score. HRQOL is assessed at baseline, 6 weeks, 12 weeks, and every 3 months thereafter up to 1 year. Key secondary outcomes include patient-reported outcomes, cardiorespiratory fitness, dietary intake, disease progression, overall survival, and cost-effectiveness. Adherence and safety are monitored throughout the intervention period. Conclusion This study will generate evidence on the effectiveness of a patient-tailored combined exercise and nutritional intervention in patients with incurable gastroesophageal adenocarcinoma. If effective for HRQOL, this intervention could be integrated into standard care for patients with incurable gastroesophageal adenocarcinoma. Trial registration clinicaltrials.gov NCT06138223. Date of trial registration: November 18, 2023 Date and version study protocol: 28-04-2025 version 3.1",

author = "Aniek Bonhof and Hiensch, \{Anouk E.\} and Wierdsma, \{Nicolette J.\} and \{Huis In {\textquoteleft}t Veld\}, \{Linde F.\} and Bakker, \{Sandra D.\} and Aart Beeker and \{Davidis-van Schoonhoven\}, Marjan and Helga Droogendijk and Drooger, \{Jan C.\} and Douma, \{Joeri A.J.\} and Goedegebuure, \{Ruben S.A.\} and \{Haj Mohammad\}, Nadia and \{van Hellemond\}, \{Irene E.G.\} and Karin Herbschleb and Janssen, \{Johan J.B.\} and Bianca Mostert and Marije Slingerland and Dirkje Sommeijer and Liesbeth Timmermans and Verschoor, \{Arjan J.\} and \{de Weger\}, \{Vincent A.\} and Harm Westdorp and Wumkes, \{Miriam L.\} and May, \{Anne M.\} and \{van Laarhoven\}, \{Hanneke W.M.\}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2026. Published by Oxford University Press.",

year = "2026",

month = apr,

doi = "10.1093/jncics/pkag006",

language = "English",

volume = "10",

journal = "JNCI Cancer Spectrum",

issn = "2515-5091",

publisher = "Oxford University Press",

number = "2",

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Bonhof, A, Hiensch, AE, Wierdsma, NJ, Huis In ‘t Veld, LF, Bakker, SD, Beeker, A, Davidis-van Schoonhoven, M, Droogendijk, H, Drooger, JC, Douma, JAJ, Goedegebuure, RSA, Haj Mohammad, N, van Hellemond, IEG, Herbschleb, K, Janssen, JJB, Mostert, B, Slingerland, M, Sommeijer, D, Timmermans, L, Verschoor, AJ, de Weger, VA, Westdorp, H, Wumkes, ML, May, AM & van Laarhoven, HWM 2026, 'Effects of exercise and diet in patients with incurable gastroesophageal cancer: the RADICES study', JNCI Cancer Spectrum, vol. 10, no. 2, pkag006. https://doi.org/10.1093/jncics/pkag006

TY - JOUR

T1 - Effects of exercise and diet in patients with incurable gastroesophageal cancer

T2 - the RADICES study

AU - Bonhof, Aniek

AU - Hiensch, Anouk E.

AU - Wierdsma, Nicolette J.

AU - Huis In ‘t Veld, Linde F.

AU - Bakker, Sandra D.

AU - Beeker, Aart

AU - Davidis-van Schoonhoven, Marjan

AU - Droogendijk, Helga

AU - Drooger, Jan C.

AU - Douma, Joeri A.J.

AU - Goedegebuure, Ruben S.A.

AU - Haj Mohammad, Nadia

AU - van Hellemond, Irene E.G.

AU - Herbschleb, Karin

AU - Janssen, Johan J.B.

AU - Mostert, Bianca

AU - Slingerland, Marije

AU - Sommeijer, Dirkje

AU - Timmermans, Liesbeth

AU - Verschoor, Arjan J.

AU - de Weger, Vincent A.

AU - Westdorp, Harm

AU - Wumkes, Miriam L.

AU - May, Anne M.

AU - van Laarhoven, Hanneke W.M.

PY - 2026/4

Y1 - 2026/4

N2 - Background Patients with incurable gastroesophageal adenocarcinoma have an impaired health-related quality of life (HRQOL). Exercise combined with nutritional support may improve this outcome. Careful evaluation of this supportive care strategy is needed to avoid burdening patients at this vulnerable stage with interventions that may offer no (meaningful) benefit. Therefore, this study aims to investigate the effects of a combined exercise and nutritional intervention on HRQOL in patients with incurable gastroesophageal adenocarcinoma. Methods RADICES (the effect of exeRcise And Diet on quality of life in patients with Incurable Cancer of Esophagus and Stomach) is a multicenter randomized controlled trial aiming to include 196 patients with incurable gastroesophageal adenocarcinoma. Participants are randomly assigned (1:1) to a patient-tailored intervention or a control group. The intervention group is provided with 2 training sessions per week and biweekly nutritional consultations, delivered by trained physiotherapists and dietitians, during 12 weeks. The control group receives usual care supplemented with general physical activity advice. The primary outcome is the difference in HRQOL between the intervention group and the control group at 12 weeks, accounting for baseline HRQOL, measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–30 summary score. HRQOL is assessed at baseline, 6 weeks, 12 weeks, and every 3 months thereafter up to 1 year. Key secondary outcomes include patient-reported outcomes, cardiorespiratory fitness, dietary intake, disease progression, overall survival, and cost-effectiveness. Adherence and safety are monitored throughout the intervention period. Conclusion This study will generate evidence on the effectiveness of a patient-tailored combined exercise and nutritional intervention in patients with incurable gastroesophageal adenocarcinoma. If effective for HRQOL, this intervention could be integrated into standard care for patients with incurable gastroesophageal adenocarcinoma. Trial registration clinicaltrials.gov NCT06138223. Date of trial registration: November 18, 2023 Date and version study protocol: 28-04-2025 version 3.1

AB - Background Patients with incurable gastroesophageal adenocarcinoma have an impaired health-related quality of life (HRQOL). Exercise combined with nutritional support may improve this outcome. Careful evaluation of this supportive care strategy is needed to avoid burdening patients at this vulnerable stage with interventions that may offer no (meaningful) benefit. Therefore, this study aims to investigate the effects of a combined exercise and nutritional intervention on HRQOL in patients with incurable gastroesophageal adenocarcinoma. Methods RADICES (the effect of exeRcise And Diet on quality of life in patients with Incurable Cancer of Esophagus and Stomach) is a multicenter randomized controlled trial aiming to include 196 patients with incurable gastroesophageal adenocarcinoma. Participants are randomly assigned (1:1) to a patient-tailored intervention or a control group. The intervention group is provided with 2 training sessions per week and biweekly nutritional consultations, delivered by trained physiotherapists and dietitians, during 12 weeks. The control group receives usual care supplemented with general physical activity advice. The primary outcome is the difference in HRQOL between the intervention group and the control group at 12 weeks, accounting for baseline HRQOL, measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–30 summary score. HRQOL is assessed at baseline, 6 weeks, 12 weeks, and every 3 months thereafter up to 1 year. Key secondary outcomes include patient-reported outcomes, cardiorespiratory fitness, dietary intake, disease progression, overall survival, and cost-effectiveness. Adherence and safety are monitored throughout the intervention period. Conclusion This study will generate evidence on the effectiveness of a patient-tailored combined exercise and nutritional intervention in patients with incurable gastroesophageal adenocarcinoma. If effective for HRQOL, this intervention could be integrated into standard care for patients with incurable gastroesophageal adenocarcinoma. Trial registration clinicaltrials.gov NCT06138223. Date of trial registration: November 18, 2023 Date and version study protocol: 28-04-2025 version 3.1

UR - https://www.scopus.com/pages/publications/105035297085

U2 - 10.1093/jncics/pkag006

DO - 10.1093/jncics/pkag006

M3 - Article

C2 - 41592243

AN - SCOPUS:105035297085

SN - 2515-5091

VL - 10

JO - JNCI Cancer Spectrum

JF - JNCI Cancer Spectrum

IS - 2

M1 - pkag006

ER -

Effects of exercise and diet in patients with incurable gastroesophageal cancer: the RADICES study

Abstract

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